Meta-Analysis Evaluating H2FPEF Score as a Prognostic Tool to Predict Mortality and Heart Failure–Related Hospitalization in Adults With Normal Left Ventricular Ejection Fraction and Dyspnea

The H2FPEF score was initially described by Reddy et al 1 Reddy YNV Carter RE Obokata M Redfield MM Simple Borlaug BA.A Evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018; 138: 861-870 Crossref PubMed Scopus (398) Google Scholar as a tool to differentiate heart failure (HF) with preserved ejection fraction (HFpEF) from noncardiac causes of dyspnea and to assist in determination of the need for further diagnostic testing in the evaluation of patients with unexplained exertional dyspnea. The score is composed of different clinical and echocardiographic variables that are related to the pathophysiology of HFpEF, including the following: a body mass index >30 kg/m2, use of ≥2 antihypertensive drugs, the presence of atrial fibrillation (AF), age >60, echocardiographic findings of pulmonary artery systolic pressure >35 mmHg, and early mitral inflow velocity and mitral annular early diastolic velocity (E/e′) ratio >9. All the parameters included in the H2FPEF score are also established prognostic factors in patients with HFpEF. Therefore, the combination of these parameters may have clinical implications in the assessment of patients with HFpEF not only for the diagnosis of HFpEF but also for prediction of prognosis. However, predicting the prognosis of patients using this scoring system is an ongoing topic of interest. We, therefore, performed a detailed systematic review and meta-analysis with the hypothesis that H2FPEF score can be used to predict mortality and HF-related hospitalization in adults with preserved left ventricular ejection fraction (LVEF) and dyspnea.